Exploring patient experiences coping with using multiple medications: a qualitative interview study.
Exploring patient experiences coping with using multiple medications: a qualitative interview study.
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DOI：
10.1136/bmjopen-2020-046860
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发表时间：
2021-11-22
期刊：
影响因子：
2.9
通讯作者：
Choudhry NK
中科院分区：
文献类型：
--
作者：
Lauffenburger JC;Haff N;McDonnell ME;Solomon DH;Antman EM;Glynn RJ;Choudhry NK
长期坚持循证药物治疗心脏代谢疾病仍然很差，尽管广泛的努力，开发和测试干预措施，并部署临床医生的绩效激励。干预的有限成功可能是由于忽视了患者的服药经验等因素。尽管临床医生可能会解决这些问题，但这些因素尚未得到充分探讨，这一点在患者使用越来越多的药物时尤为重要。其目的是探讨患者的观点，服药，药物特性，坚持的障碍，应对策略，他们的药物治疗方案。个人，面对面，半结构化定性访谈。城市医疗体系。26名成人服用≥2种口服药物治疗糖尿病、高血压或高血脂症，但不依从。访谈进行了数字记录和转录。使用开发的代码分析数据，以生成主题。选择有代表性的引文来说明主题。参与者的平均年龄为55岁，46%为女性，39%为非白人。六个关键主题被确定：（1）药物服用被视为一个非常不方便的行动（2）由于不便或疾病感知而产生的负面影响;（3）实际药物治疗方案可能与处方方案存在很大差异;（4）某些药物性质（特别是尺寸和外观与其他产品相似）可能导致粘附偏差;（5）制定多种应对策略以克服障碍;（6）提出建议，使服药更容易（包括降低药物成本，简化方案或给药频率，并创造更可口的药物）。依从性差的患者经常发现服用处方药是不可取的，并且部分由于药物本身的性质和他们为克服服药挑战而制定的应对策略而与处方药不同。减少药物使用的不便和根据个人需要定制药物的干预措施可能是一个受欢迎的发展。
Long-term adherence to evidence-based medications in cardiometabolic diseases remains poor, despite extensive efforts to develop and test interventions and deploy clinician performance incentives. The limited success of interventions may be due to ignored factors such as patients’ experience of medication-taking. Despite being potentially addressable by clinicians, these factors have not been sufficiently explored, which is particularly important as patients use increasing numbers of medications. The aim is to explore patient perspectives on medication-taking, medication properties that are barriers to adherence, and coping strategies for their medication regimen. Individual, in-person, semistructured qualitative interviews. Urban healthcare system. Twenty-six adults taking ≥2 oral medications for diabetes, hypertension or hyperlipidaemia with non-adherence. Interviews were digitally recorded and transcribed. Data were analysed using developed codes to generate themes. Representative quotations were selected to illustrate themes. Participants’ mean age was 55 years, 46% were female and 39% were non-white. Six key themes were identified: (1) medication-taking viewed as a highly inconvenient action (that patients struggle to remember to do); (2) negative implications because of inconvenience or illness perceptions; (3) actual medication regimens can deviate substantially from prescribed regimens; (4) certain medication properties (especially size and similar appearance with others) may contribute to adherence deviations; (5) development of numerous coping strategies to overcome barriers and (6) suggestions to make medication-taking easier (including reducing drug costs, simplifying regimen or dosing frequency and creating more palatable medications). Patients with poor adherence often find taking prescription medications to be undesirable and take them differently than prescribed in part due to properties of the medications themselves and coping strategies they have developed to overcome medication-taking challenges. Interventions that reduce the inconvenience of medication use and tailor medications to individual needs may be a welcome development.
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DOI：
10.1037/a0040388
发表时间：
2016-10
期刊：
The American psychologist
影响因子：
--
作者：
Gonzalez JS;Tanenbaum ML;Commissariat PV
通讯作者：
Commissariat PV
DOI：
10.1016/j.curtheres.2015.08.002
发表时间：
2015-12
期刊：
Current therapeutic research, clinical and experimental
影响因子：
--
作者：
Fields J;Go JT;Schulze KS
通讯作者：
Schulze KS
影响因子：
2.8
作者：
Lauffenburger, Julie C.;Farley, Joel F.;Fang, Gang
通讯作者：
Fang, Gang
影响因子：
39.2
作者：
Kesselheim, Aaron S.;Bykov, Katsiaryna;Choudhry, Niteesh K.
通讯作者：
Choudhry, Niteesh K.
影响因子：
2.1
作者：
Doucette, William R.;Farris, Karen B.;Barnes, Jennifer M.
通讯作者：
Barnes, Jennifer M.